Product Sample & Evaluation Request Form

Professional Profile

Full Name

 

First Name

Last Name

Company/Organization Name

Job Title/Role

Industry

Email Address

Phone Number

Website/Social Media Link

Current Annual Spend in this Category

Sample Selection

Product Name/SKU Requested

Quantity Needed (e.g., 1 unit, 5ml vial, etc.)

Variation (if applicable): (Color, scent, size, or model number)

Business Use Case & Evaluation

Primary Purpose of Request

Who will be performing the testing?

Evaluation Timeline: How many days or weeks do you require for product testing?

Success Criteria: What specific features or results are you looking for during this trial?

Projected Monthly/Annual Volume: (If the evaluation is successful)

Projected Launch/Purchase Date

Decision-Making Process

Shipping & Logistics

Shipping Address

 

Street Address

Street Address Line 2

City

State/Province

Postal/Zip Code

Preferred Shipping Method

Shipping Account Number (Optional): (e.g., FedEx/UPS/DHL if the requester is paying for freight)

Is this a rush request?

Terms and Conditions

Note: By submitting this request, the requester agrees to provide feedback within 14 days of receiving the sample. Samples are provided for evaluation purposes only and are not for resale.

 

Signature

Form Template Insights

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Component Breakdown & Strategy

1. Identity Verification (The Header)

This section is about Lead Scoring. By asking for a company name and a professional email address, you can quickly distinguish between a "freebie seeker" and a genuine business partner.

  • The Job Title Field: This tells you if you are talking to the "End User" (who cares about features) or the "Decision Maker" (who cares about price and bulk logistics).
  • Website/Social Links: Use these to verify the scale of the requester's business before you commit your inventory.

2. The Scope of Request

Specificity prevents waste. By forcing a requester to choose a specific SKU or variation, you ensure they have actually researched your catalog.

  • Quantity Limits: Explicitly asking for the quantity needed allows you to push back if a request seems excessive for a "sample." It sets a standard that these items are for testing, not for stocking their shelves.

3. Intent & Projection (The "Vetting" Core)

This is the most valuable part of the form for your internal data.

  • Primary Purpose: This categorizes your leads. A "Content Creator" needs high-resolution assets and brand guidelines, while a "Wholesale Partner" needs spec sheets and bulk pricing.
  • Projected Volume: This helps you prioritize your shipping budget. You should send a sample faster to a lead projecting 1,000 units a month than to one projecting 10 units a year.
  • Success Criteria: Knowing what they are looking for (e.g., "durability," "scent longevity," or "ease of assembly") gives your sales team the exact talking points they need when following up.

4. Logistics & Accountability

Small businesses often struggle with the cost of shipping samples.

  • Shipping Accounts: Offering a field for their own courier account (FedEx/UPS) is a subtle way to filter for serious professional entities. A business willing to pay for the shipping of a free sample is highly likely to convert into a paying customer.
  • The Timeline: By making the requester commit to a timeframe for their evaluation, you create a natural opening for your follow-up call. You aren't "pestering" them; you are checking in on the date they provided.


Mandatory Questions Recommendation

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Mandatory Field Analysis

Below are the essential fields for a Product Sample & Evaluation Request Form and the operational reasons for their inclusion.

1. Full Name and Professional Email Address

  • The "Why": You need a direct line of communication with a specific individual. Generic emails (like @gmail or @yahoo) are often used for personal samples. A professional domain (e.g., name@company.com) validates that the request is coming from a business entity.
  • Operational Benefit: This allows you to perform basic due diligence by looking up the sender on professional networking sites to confirm their authority to make purchasing decisions.

2. Company Name and Website

  • The "Why": A business cannot evaluate a product for commercial use if the business doesn't exist. The website serves as a portfolio of their current work or retail presence.
  • Operational Benefit: It helps you understand their brand positioning. If their website doesn't align with your product's quality or price point, you can decline the request before wasting inventory and shipping costs.

3. Primary Purpose of Request

  • The "Why": You must know if the sample is for internal quality testing, social media promotion, or a potential large-scale contract.
  • Operational Benefit: This determines which "department" in your small business handles the lead. A request for "content creation" requires your marketing materials, while "bulk purchase" requires your wholesale price list and lead times.

4. Projected Purchase Volume (Post-Evaluation)

  • The "Why": This is the most critical metric for your Return on Investment (ROI). If a sample costs you $50 to send, but the potential client only needs 5 units a year, the math may not work in your favor.
  • Operational Benefit: It allows you to rank requests. You can prioritize shipping to the "Big Fish" leads who have the capacity for high-volume orders.

5. Evaluation Success Criteria

  • The "Why": You need to know exactly what "pass" or "fail" looks like for the customer. For example: "Must withstand 200°C" or "Must be hypoallergenic."
  • Operational Benefit: If their success criteria are something your product cannot meet, you can inform them immediately. This saves the cost of the sample and prevents a negative review later.

6. Expected Evaluation Timeline

  • The "Why": This sets a firm date for the conclusion of the trial. Without a deadline, samples often sit on a desk forgotten.
  • Operational Benefit: This populates your sales calendar. It gives your team a specific date to call the lead and ask, "The 14-day trial you requested is over; are we moving forward with a purchase order?"

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